Abstract
It is widely believed that fractures of the first rib are associated with more severe injuries than fractures of other ribs. To confirm or refute that belief, we conducted a retrospective review of 168 patients with major blunt trauma resulting in fractures of the upper ribs treated at the North Carolina Baptist Hospital. A comparison of morbidity and mortality rates in relation to highest rib fractured showed essentially no correlation. We concluded that all patients with deceleration or crushing injuries involving upper-rib fractures must be suspected of having significant multiple organ system trauma and evaluated accordingly.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Appelbaum A., Karp R. B., Kirklin J. W. Surgical treatment for closed thoracic aortic injuries. J Thorac Cardiovasc Surg. 1976 Mar;71(3):458–460. [PubMed] [Google Scholar]
- Bassett J. S., Gibson R. D., Wilson R. F. Blunt injuries to the chest. J Trauma. 1968 May;8(3):418–429. doi: 10.1097/00005373-196805000-00008. [DOI] [PubMed] [Google Scholar]
- Becker D. P., Miller J. D., Ward J. D., Greenberg R. P., Young H. F., Sakalas R. The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg. 1977 Oct;47(4):491–502. doi: 10.3171/jns.1977.47.4.0491. [DOI] [PubMed] [Google Scholar]
- DeMeules J. E., Cramer G., Perry J. F., Jr Rupture of aorta and great vessels due to blunt thoracic trauma. J Thorac Cardiovasc Surg. 1971 Mar;61(3):438–442. [PubMed] [Google Scholar]
- Griffith G. L., Todd E. P., McMillin R. D., Zeok J. V., Dillon M. L., Utley J. R., Griffen W. O. Acute traumatic hemothorax. Ann Thorac Surg. 1978 Sep;26(3):204–207. doi: 10.1016/s0003-4975(10)63670-3. [DOI] [PubMed] [Google Scholar]
- HARRISON W. H., Jr, GRAY A. R., COUVES C. M., HOWARD J. M. Severe non-penetrating injuries to the chest; clinical results in the management of 216 patients. Am J Surg. 1960 Nov;100:715–722. doi: 10.1016/0002-9610(60)90414-1. [DOI] [PubMed] [Google Scholar]
- Jones J. W., Hewitt R. L., Drapanas T. Cardiac contusion: a capricious syndrome. Ann Surg. 1975 May;181(5):567–574. doi: 10.1097/00000658-197505000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirsh M. M., Behrendt D. M., Orringer M. B., Gago O., Gray L. A., Jr, Mills L. J., Walter J. F., Sloan H. The treatment of acute traumatic rupture of the aorta: a 10-year experience. Ann Surg. 1976 Sep;184(3):308–316. doi: 10.1097/00000658-197609000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirsh M. M., Crane J. D., Kahn D. R., Gago O., Moores W. Y., Redman H., Bookstein J. J., Sloan H. Roentgenographic evaluation of traumatic rupture of the aorta. Surg Gynecol Obstet. 1970 Nov;131(5):900–904. [PubMed] [Google Scholar]
- Kish G., Kozloff L., Joseph W. L., Adkins P. C. Indications for early thoracotomy in the management of chest trauma. Ann Thorac Surg. 1976 Jul;22(1):23–28. doi: 10.1016/s0003-4975(10)63946-x. [DOI] [PubMed] [Google Scholar]
- Marsh D. G., Sturm J. T. Traumatic aortic rupture: roentgenographic indications for angiography. Ann Thorac Surg. 1976 Apr;21(4):337–340. doi: 10.1016/s0003-4975(10)64323-8. [DOI] [PubMed] [Google Scholar]
- Perry J. F., Jr, DeMeules J. E., Root H. D. Diagnostic peritoneal lavage in blunt abdominal trauma. Surg Gynecol Obstet. 1970 Oct;131(4):742–744. [PubMed] [Google Scholar]
- Pickard L. R., Mattox K. L., Espada R., Beall A. C., Jr, DeBakey M. E. Transection of the descending thoracic aorta secondary to blunt trauma. J Trauma. 1977 Oct;17(10):749–753. doi: 10.1097/00005373-197710000-00001. [DOI] [PubMed] [Google Scholar]
- ROOT H. D., HAUSER C. W., MCKINLEY C. R., LAFAVE J. W., MENDIOLA R. P., Jr DIAGNOSTIC PERITONEAL LAVAGE. Surgery. 1965 May;57:633–637. [PubMed] [Google Scholar]
- Richardson J. D., McElvein R. B., Trinkle J. K. First rib fracture: a hallmark of severe trauma. Ann Surg. 1975 Mar;181(3):251–254. doi: 10.1097/00000658-197503000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sturm J. T., Marsh D. G., Bodily K. C. Ruptured thoracic aorta: evolving radiological concepts. Surgery. 1979 Apr;85(4):363–367. [PubMed] [Google Scholar]
- Thomas A. N., Goodman P. C., Roon A. J. Role of angiography in cervicothoracic trauma. J Thorac Cardiovasc Surg. 1978 Nov;76(5):633–638. [PubMed] [Google Scholar]
- Turney S. Z., Attar S., Ayella R., Cowley R. A., McLaughlin J. Traumatic rupture of the aorta. A five-year experience. J Thorac Cardiovasc Surg. 1976 Nov;72(5):727–734. [PubMed] [Google Scholar]
- Wilson J. M., Thomas A. N., Goodman P. C., Lewis F. R. Severe chest trauma. Morbidity implication. Arch Surg. 1978 Jul;113(7):846–849. doi: 10.1001/archsurg.1978.01370190068011. [DOI] [PubMed] [Google Scholar]